Monday, November 29, 2010

Anacetrapib: The drug trial results

A recent trial of an LDL lowering and HDL increasing drug, ie a perfect lipid profile.
Unfortunately 4 times more people died on the drug rather than the placebo.

Interesting parts in the document is the table 4 on page 9

Number of deaths on drug = 4, placebo = 1.

There were many more hospitalizations for the placebo group. Possibly because their lipid profile were not good, so doctors were checking other markers. For the drug lipid profile was perfect so doctors would not have cared checking for the other markers.

The adverse result of the drug could be because of the effect of the lipid profile on Doctors psyche.

Another interesting thing was that Drug related adverse events was nearly same for placebo as well. I don't know what kind of placebo they were using, that would cause an adverse effect.

Apparently the results were considered inconclusive and they are planning to have a bigger study. People are lining up to die on the drug.

The take back from this. A good lipid profile does not mean that you don't have heart problems. A bad lipid profile does not mean you have a heart problem. Essentially lipid profile does not matter for heart disease.

If you do have a good lipid profile your doctor might ignore your heart problems. If you have a bad lipid profile your doctor might prescribe preventive medicines with significant side effects (called statins), even though you have no heart problems.

If you suspect of heart problems get a calcium score, and try to fix that. Don't put too much faith into lipid profile. And diet that changes lipid profile also doesn't matter, essentially it is good to eat butter, even though it might raise your LDL.

Personally it did not happen to me. Mine went down 20 points when I started eating lots of ghee/butter.

Aged Cheeses are known to help in reducing coronary plaque, via a little known vitamin K2, which is also found in ghee/butter.

Wednesday, November 24, 2010

Apocalypse: My theory and delaying it

Human population is much bigger than what the earth can support sustainably.

The current farm practices are incredibly wasteful. We eat so much grains. The grains do not grow in a void. They grow on a stalk. This stalk is thrown away. We are not utilizing this stalk as much as we should. This stalk can be used to grow animals, which provide more food. Another problem with grains is that the stalk can only be used when it is dried and literally dead. A better solution would be to use vegetables, where the leaves can be used for animals while the plant is still living. This will provide better nutrients to animals. And in turn will provide better nutrients to us.

We are taking out micro-nutrients from the soil at an incredibly faster rate.
Add to the fact that we do not send back the human waste into the same soil where the food came from. The result is micro-nutrient depletion. It would be better to eat local. And fix the human waste distribution system to convert it into fertilizers and send it back to the land where the food came from. We will need to avoid chemicals that can be harmful for cleaning the toilets, so that the human waste can be used without trouble for fertilizing the land.

We are growing food by using artificial fertilizers. This does not seem to be very sustainable. We do not know what nutrients the fertilizers are missing that might be critical. The plant researchers are not omniscient. The micro-nutrients may not be fixable by just adding the constituent minerals.

I suspect that in a not so distant future, much of the land will start becoming barren. It will not grow anything. This will be the age of enormous deserts.
What will humans do?

I believe there will be a food shortage of a magnitude never seen before. I hope we don't reach this stage in my life time. It will be a living hell. I believe most of the technology will be lost, except for some technical people living from land away from population.

I hope people will understand and start to implement better practices to delay this horrific possibility till we find a way to control population. I believe the population will start to reduce once most of the women population is educated.

Sunday, November 21, 2010

today's reading list.
It is an excellent paper, giving the rise and fall of ketogenic diets. It also shows that 2-3 weeks are required to get adapted to ketogenic diets. Also the good range of protein is 1.2gm/kg to 1.7gm/kg for ketogenic diets. Lower levels tend to lose muscle mass and higher tend to cause problems. Also it shows that sodium potassium intake is of paramount importance in ketogenic diets.
Very important article showing that good diets can fail because of minor elements.
The third in a series on pitfalls of low carb diets.
A description of how VLDL and LDL are related and how they relate to carbs.
One reason why children should be fed exclusively with mothers milk till supplementary solid foods are required. Feeding the formula may insert adult bacteria in the gut of the child which will rob important nutrients. Interestingly complex sugar molecules in human milk are different compared to other animals and support only a very specific type of bacteria. The human milk will not support other bacteria and will help them die out.
It seems high carb/low fat diet can be better for weight loss than low carb/high fat diets. It depends on insulin resistance. This is true only when you restrict calories to equal amounts. In real life it is easier to restrict calories on low carb diets.
This is good. It shows that insulin is non-inflammatory, while all the time I had been assuming that insulin is problematic.

Thursday, November 18, 2010

Epilepsy and Ketogenic diet

New York Times has a very good article on Ketogenic diet helping Epilepsy patients. The Author has a son who suffers from Epileptic seizures.

If you want to know how to control Epilepsy, you must read this article.

It is funny that the author thinks that he is slowly killing his son by feeding him bad fat and cholesterol, but it is the only diet which will let him have some life. The seizures are reduced to a very small frequency with a ketogenic diet.

A ketogenic diet is where the body does not have enough glucose, and must convert fat to create ketones for feeding the brain. It is a very high fat diet. 80-90% of calories come from fat, rest from protein. There is only trace amounts of carbs.

Unfortunately, the mainstream medicine has no intention of coming to grips with fat and cholesterol are good logic. It will be a very bad year for them, if they are forced to change. People will finally stop feeling sick, and doctors will be without job.

The Keto diet they are following is very restrictive. They have to use exactly the same percentage of fat and protein and carb. The doctors have prescribed fruits instead of vegetables for the carb source.

Somehow they don't distinguish between fats, but they are using mostly good fats.

The author says that the body prefers running on glucose, when in reality it does not. Glucose is like oxygen, it is required for various functions of the body, and needs to be there. But just like oxygen needs to be at a level of 21% to be good for us, glucose also has a specific level that is good in our diet. Its not like you can have as much as you want and will not feel any trouble.

The acceptable glucose level is determined by the health of the body. Anything goes wrong and the ability to use glucose goes down. An obese person has compromised their ability to use glucose.

There are two types of tissues in the body, neurons and other cells. Neurons can only use glucose and Ketones as fuels. While other cells can use glucose and fat for fuel. In diabetics the ability to burn glucose is lost by the cells of the body.
In some neurological disorders the ability to burn glucose is lost by the neurons.
Alzheimer's is like a diabetes of the brain. The brain is no longer able to use glucose and if the body does not have enough ketones it starves and dies.

Epilepsy is a different type of disease. Some neurons are not burning glucose properly. It is possibly causing its electrical circuitry to get affected. The only option is to avoid letting glucose get to the brain cells. This is only possible by reducing the supply of glucose to the brain as much as possible and supplement it with Ketones. It is important to keep the proteins also at minimum, because in excess they will convert to glucose providing excess glucose.

A ketogenic diet does just that. It will be helpful to use a more paleo friendly ketogenic diet, because I believe that there are some other factors from the diet that are affecting the patient. It could be wheat, it could be milk also.

I believe the authors son is not getting rid of it fast enough because he is still getting milk/cream. They should try getting rid of it. But they are following doctors advice instead of experimenting on their own. Their child is unique, they need to tailor the diet for him specifically. They need to find the problems in the diet.

Unfortunately doctors have a very reductionist attitude towards diet. So for them ketogenic diet just means a specific ratio of nutrients. They don't care which foods are giving those nutrients. Are there any anti-nutrients.

Tuesday, November 16, 2010

Cancer: A plague caused by modern lifestyle.

Otto Warburg was given a Nobel Prize for his research on Cancer in 1931. He discovered that cells become cancerous when their mitochondria are destroyed. This results in the cells not able to do aerobic energy production. The only option left to them is anaerobic one. This is very inefficient, and works only on glucose. It results in them requiring a whole lot of glucose.

One way to control cancer is to reduce glucose in the diet. This will prevent the cancer cells from getting glucose from the body as easily, but they will still get some. The body will be converting a lot of protein into glucose to provide the required glucose, so the diet must be quite high in protein, even for a non-vegetarian. This strategy works when the cancer is still very small. When it is big, this strategy may be of only marginal help.

One problem with this strategy is that not all people are able to live well on a very low carb diet. In this diet you would have to be below 50gms of carb, and protein above 2.5gm/Kg lean body weight. This is hard for many people. You will require some supplementation to handle the lack of specific nutrients because of too few vegetables in the diet. Some people have been able to control their cancer this way. The good thing is that it has no adverse effects, and you can live your life to the fullest.

Chemotherapy is known to help some people and is generally bad for most. It could be used as a last resort. I have heard that very long water fasting (more than 3 days) before the therapy helps in dealing with the effects of chemotherapy. The fasting prepares the body for very adverse situation, and when the body is ready it is able to handle the damage caused by chemotherapy much better.

This is all that I know of handling cancer.

Now for the causes of cancer.

Cancer is caused by any number of situations. From the environmental radiation, carcinogens, etc. The body has mechanisms to deal with cancerous cells. It will kill cancerous cells, before they can cause damage. It requires vitamin D3 to fight the cancer cells, or any other infection for that matter, and even to fight bad agents in the food like Wheat Germ. Wheat germ is known to reduce vitamin D3 levels in the blood.

Unfortunately with current lifestyle of working during the day covered under a roof has made it difficult to get enough vitamin D3. Fortunately, you can buy Vitamin D3 capsules or eat enough wild fish.
Cancer is know to occur more frequently in the Cities than the villages. It also becomes more common as you go away from the equator.

Vitamin D3 is very very critical. Not just for cancer. If you don't want to get it artificially, eat enough fish, and get some noon sun (around an hour in India) lying in the sun. It will be difficult in the beginning, increase it slowly. Vitamin D3 is the reason why sun bathing is so popular in Western countries, they get so little sun.

Another factor is cholesterol. It is known to be inversely related to cancer. Cancer normally happens to people below 180mg/dl of total cholesterol. Cholesterol like Vitamin D3 is required for fighting cancer and external agents. Low cholesterol also makes you more vulnerable to diseases. I know 180mg/dl is now considered to be too high for heart disease. But this is a myth.

Insoluble fiber is known to cause cancer in the Colon, due to the constant abrasion, same process that causes lung cancer due to smoking.

High Omega6 to Omega3 ratio is known to be associated with cancer. That ratio also tends to reduce cholesterol so it may be that refined oil consumption is related to cancer because of its effect on Cholesterol. It can be directly responsible as the high ratio is highly inflammatory. The inflammation may also cause cancer. We don't know the mechanism behind it, only the association. The high ratio is also known to be associated very closely with heart disease, but there also we don't know the actual mechanism.

Some resources for finding information on Cancer.
Dr. David Servan-Schreiber
Anticancer: A New Way Of Life - David Servan-Schreiber
Some of his lectures

His blog

Interesting article. It asks the same things, low carb, low omega6, high omega3.The only thing missing is Vitamin D3 and cholesterol. The last I think are the most important.
There are other articles at

Dr.Thomas Seyfried
Paper on Brain Tumors and cure.
Paper on cure of glioblastoma multiforme. It is the most common and most aggressive type of primary brain tumor in humans.

Myth: Exercise can help you lose weight.

Exercise makes you feel hungry. If you feed after an exercise you will eat enough to balance out the calories that you burnt. There is a thing called homeostasis. It tends to keep the body composition stable. The homeostasis is based on a n...umber hormones that work together to keep body composition in balance. We will look at the homeostasis mechanisms in the diet myth article.

So yes you will need to couple the exercise with a diet to reduce weight, otherwise you will always compensate in your diet.

If you are required to diet anyway, then what is the point of doing exercise. Exercise helps in the following ways for priming the body to lose fat instead of muscles.

1) While you are dieting to lose weight, you will lose muscle as well. Muscles are a very important part of our body, losing them is not good. Exercise tells the body that those muscles are required and it should keep them around. Exercise helps keep the muscle loss to a minimum.

2) Exercise can also help by keeping the metabolic rate higher, and there by increasing fat burn rate. You don't need to burn much fat during the exercise, although exercise will do so, but increasing metabolic rate helps burn fat all day long.

3) Exercise also helps in hormonal balance. There are several hormones that help burn fat, the most important of them is the testosterone, the hormone that also builds muscle. Women also have small amounts of testosterone, and exercise will also help them burn fat.

4) Exercise also helps in reducing glycogen storage in muscles. This helps in reducing insulin resistance. Allowing the insulin levels to go lower faster and helps in increasing fat loss.

Not all exercises are created equal. Some exercises aid fat loss more than others. Weight training and High Intensity Interval Training (HIIT) helps more than aerobic exercises.

1) Multi-functional Weight training and HIIT, help exercise all muscles of the body, preserving them. Aerobic exercises like running generally, exercise only a few muscles.

2) Wight training is the best for building muscles for increasing the metabolic rate. HIIT follows closely. Aerobic exercises do not help build muscles.

3) HIIT is known to be the most effective in increasing testosterone. Weight training follows very closely. Aerobic exercises generally do not help in this regard.

4) Glycogen stores are for emergency energy requirement. Oxygen is used for burning fat to supply energy in the normal case. Glycogen is used when the muscles require to generate energy faster than blood can supply oxygen. In this case glycogen is burnt anaerobically to produce energy. This is by definition an anaerobic activity, and aerobic exercises cannot help here. HIIT is the best in this regard as it tends to maximize the Oxygen requirement, because of exceeding it.

Believe it or not, exercise does have negative consequences if not done properly.

Exercise causes wear and tear of muscles ligaments, etc. There must be enough spacing in the exercise to recuperate. Do not over do exercise. There are terms for too much exercise, chronic cardio for people who do too much aerobic exercise, and overtraining for people who do HIIT and Weight Training. Weight Training/HIIT generally requires a minimum of 48 hours break.

Aerobic exercises should also involve breaks depending on the length and effort in the exercise. Take at least a week off after a half marathon, and don't do full marathons more than once a month. Generally you do not want to run more than half an hour everyday, and not more than 3, 1 hour runs a week.

The most important indicator for chronic cardio and over training is lack of appetite and all day feeling of tiredness.

Avoid weight machines that provide balancing automatically. This causes the balancing muscles to be underdeveloped compared to the main muscles, and can cause accidents if you try to use your full muscle power in real life situation. It is best to use a bar-bell and dumb bell. To get the most benefit of weight training, use compound lifts instead of isolation movements. Isolation movements require machines and exercise very few muscles, which is inefficient.

To sum it up.
Exercise in isolation does not help in weight loss. Dieting in isolation can help in weight loss. Weight training and HIIT are the best ways to increase your fat loss, and resist muscle loss. Be careful how you exercise.

Myth: For weight loss Calorie reduction is what matters. All diets will result in same losses, provided same calorie reduction is done.

Fact: Not all diets are created equal for losing weight.
Fact: Not everybody reacts to diets the same way. Some people have trouble gaining weight, others have trouble losing weight. On an average men find it easier to lose fat than women. Post menopausal women find it much harder to lose weight than other women. Older people find it tougher to lose weight compared to younger people. These all conditions are due to hormone status, and shows that calories are not the most important thing for fat loss. The 4 hormones which cause the above differences are Insulin, testosterone, estrogen, and human growth hormone.

Insulin is the most important hormone affecting weight gain and loss. Others are much less important.

Insulin is a storage hormone. While it is high the body is in storage mode. It will store all nutrients that are available. Glucose and fat are stored in the fat cells. It will not attempt to use the fat stored in the fat cells. The body will get all its energy from glucose.

Insulin's basic function is not getting rid of glucose, but humans, who are the only species to eat a whole lot of easily digestible carbohydrates, have evolved to use the insulin for this purpose. Glucose in blood is very bad. The tolerable limit is like a teaspoon in the whole blood of the body. People generally do eat a lot more than this amount. The body needs to get rid of the excess as fast as possible. This is where insulin helps. It instructs the body to use glucose only (fat metabolism is stopped). It instructs the body to store the glucose where ever possible. The glucose is stored as glycogen in muscles and liver. When glycogen stores are nearly full, glucose is converted in to saturated fats and stored in fat cells.

People with insulin resistance (ie lack of good sugar control, or (pre)diabetes) have constantly high insulin, as the body is not not responding to insulin properly and takes a lot more time to control glucose. The much longer high insulin period means that they have trouble losing fat. People with diabetes have different problem, they are so insulin resistant that even their fat cells don't respond to insulin. In this case fat cells will not take in anymore glucose/fat but will release fat. These people lose weight, because they cannot store anything anymore, including important nutrients, like proteins, calcium, etc.

So what do we learn here. Any diet that keeps the insulin low will be superior to a diet which does not do so. This is the reason why low carb diets work really well for weight loss. This does not mean that you can eat as much as you want and will still lose weight. It just means that given a calorie reduction the body will respond to low carb diets more easily.

Actually low carb diets in the initial few months will help people lose weight without calorie counting. The homeostasis system will prevent people from over eating.

There is even more benefits of going very low carb diets in the initial few months. This relies on the fact that we need glucose to store fat. The glucose molecule is cleaved into two glycerol molecules and fat is attached to each Carbon atom and converted into triglyceride. This triglyceride gets stored into fat cells. If there is not enough glucose this activity does not happen. There is another mechanism to store fat, in low glucose conditions, but that requires consistent very long low carb period. So for the initial few months the fat is free (only when doing very low carb <50gm/day, or coupled with very high physical activity). Not all people react well to very low carb diets. Diabetics may still need to use very low carb diets (be very careful, with blood sugar levels), even though they may not feel the best on it.

Eating less will help you lose weight, but the issue with eating less is that you are getting less nutrients also. If you stay too long without enough nutrients you will get nutritional deficiencies. So you want to eat highly nutritious foods during dieting. Contrary to popular belief grains are not very nutritious. You can compare them to any kind of vegetables/fruits/meat to see the difference. In addition high phytic content grains like wheat also prevent proper absorption of certain nutrients like Zinc, magnesium. It is important to up the vegetable/meat content of the diet during dieting. Vegetables are also much lower carb than grains and legumes.

Protein is a highly thermogenic nutrient. When diet contains a lot more protein then most of it gets converted to glucose. This conversion is highly thermogenic. It increases metabolic rate of the body. A higher metabolic rate increases the speed at which body burns fat. It also provides raw material, and helps prevent muscle loss. It is also very helpful in keeping a person satiated.

Fat is a good energy filler, as it does not affect insulin. It is good to increase fat percentage in the diet to help keep carbs in the diet low. Medium chain fatty acids are known to not get stored in the body, as they directly convert to ketones. Coconut oil is made up of mostly MCFA. This property is useful for keeping satiated without storing fat. Pastured Butter/Ghee provide important fat soluble nutrients, contrary to conventional advice that butter/ghee are bad for health.

Going low on calories can be detrimental, if done for long. As the body gets into starvation mode and reduces metabolic rate. This normally happens after 3 days, and then again at around 2 weeks of time. It is best to eat more once a week to keep this effect from kicking in. The duration is same even if we are fasting. This might sound counter intuitive but fasting increased human growth hormone, while eating less calories does not do so. The HGH production delays the reduction in metabolic rate.

It is not necessary to be all the time low carb. It depends on insulin resistance. If your insulin resistance is low, then you will get benefit of low carb even if you are low carb only some of the time, ie your insulin goes below the threshold required to metabolize fat some of the time. The benefits are increased if you go low carb in the evening, as the duration of low carb extends during the sleep. Fasting will also help as fasting is also a period of low insulin.

To Recap.
1) All people react differently to diets.
2) Hormonal status affects weight loss, particularly insulin production and resistance.
3) Low carb is better than high carb for fat loss.
4) Very low carb is better, for some people, and required for others.
5) Protein is important.
6) Think about nutrients during weight loss. You might go low on them.
7) Evenings are the best time to go low carb, if not doing it consistently.
8) Fasting is great, but start slowly and carefully.
9) Do not eat consistently the same amount everyday. Have cheat days ie high calorie days.

Friday, November 12, 2010

Myth: Cholesterol in diet causes heart disease.

Fact: Dietary cholesterol has no linkage to the cholesterol in Blood.
Cholesterol in blood closely tracks the carbohydrates in the diet, but not the cholesterol.
Fact: Cholesterol has little to do with heart disease.

Carbohydrates in diet that cannot be used directly for storage as glycogen or as fuel immediately, is converted to saturated fatty acids. These fat particles are then joined together with a glycerol phosphate molecule to create a triglyceride molecule.

The triglyceride molecules are shipped to the fat cells (adipose tissue) in VLDL particles. VLDL particles become LDL particles after delivering the triglycerides. Such LDL particles are small and dense. On a low carb high saturated fat diet the LDL particles become large and fluffy.

The Cholesterol particles are created on demand by the liver depending on the amount of triglycerides produced. The liver will use the cholesterol obtained from diet and will create the balance.

Any extra cholesterol from the diet will be broken down into its constituents and will be used for fuel, as these are basically fat and protein.

The best way to reduce LDL cholesterol is to reduce carbohydrates in the diet or fast. Both will have the same result of reducing carbs in the diet. It doesn't matter whether you are eating cholesterol or not.

Cholesterol does not have any bearing on heart disease. It is just an indication of your diet. There is the case of small dense LDL cholesterol, which does have a bearing on heart disease. But it does not cause heart disease, but it can make it worse.

The LDL particle's membrane is made up of Omega6 poly unsaturated fatty acids, which have a tendency to go rancid. The small sized LDL particles can get trapped into the arteries if it is not in a good condition. The trapped LDL particles stay too long and get rancid. This causes the white blood cells to come to eat them which get stuck with them. Eventually this starts the plaque. Incidently the plaque need not be made up of calcium. That is another issue.

The arteries get bad due to several reasons. A couple of them are that there is not enough copper or if you get a bacterial infection. The bacterial infections is enough to cause the plaque by itself.

Calcium deposition generally happens if Vitamin K2 is missing or in inadequate quantity.

Strokes happen if you get blood clots in the arteries, and they get stuck in a place where the artery has heavy plaque. The reason why blood clots in arteries is O6:O3 imbalance. That is one of the reasons why high omega6 oils must be avoided. This includes all vegetable oils except coconut oil, Extra Virgin Olive Oil, and possibly mustard oil.

Cholesterol levels can become high in blood if Liver is not controlling the level of cholesterol in blood. This can be duet to several reasons. There is familial hypercholestramia, which is a genetic condition. Then there is liver cancer. It could possibly happen due to liver cirrhosis, which is just a fancy name for scarred liver. The liver gets scarred due to too much sugar or alcohol.

I hope this article helps people understand what would help in case of Heart Disease. At least low fat diets will make the problem worse.

Thursday, November 11, 2010

Myth: Skipping breakfast is a bad thing.

So how many people believe that skipping breakfast is a very bad thing.

Does it cause stomach ulcers as some people believe?

Also you must have heard that you should eat breakfast like a king, lunch like a prince, and supper like a pauper.

So is there any truth in it?
Not much really.

The result comes from badly designed epidemiological aka observational studies. A rhetorical question: Are there any well designed observational studies?

Most people skipping breakfast eat some junk on the go. This skews up the result so much that you see bad results, even though the results are due to the junk food rather than skipping breakfast.

There is some truth to eating breakfast like a king quote. The benefit comes from the eating supper like a pauper, not from the eating breakfast like a king.

Some people also think that skipping breakfast will cause stomach ulcers. This is also hogwash, now we know that ulcers are produced due to Halicobacter Pylori bacteria. The bacteria lives on Hydrogen released from digestion in the small intestines. Most of the hydrogen is produced while metabolizing fructose. So ulcers are due to consuming sugary foods. That is also associated with eating junk on the go.

What you should eat depends on insulin resistance. If you have a good working insulin system, you will not have any trouble as most kids can put away junk like anything and still look healthy.

It normally takes a long time (around 20years) for the metabolic system to get disrupted. This is why people start to get fat between 20-25years of age. Although now children are getting a damaged metabolism from their parents, who do not supply enough nutrients to the growing child by not breast feeding, and giving the harmful packaged baby food. I regret doing it for my son, but I was unaware. I can only hope to make others aware.

If your metabolic system is sane and you don't have insulin resistance you will not feel hungry all the time, and you don't require snacking. Notice how children will say most of the time that they are not hungry and then we force them to eat.

If you have fixed your metabolic system you can eat when you want. It doesn't matter.

Now that I have fixed my metabolic system and the insulin resistance, I regularly skip breakfast. In fact most of the days I am eating only two meals, lunch and dinner. It is also a wonderful way to keep calorie consumption down. I like to eat big meals. Now by skipping breakfast I can do that two times a day, and still not gain weight ;-).